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01 October 2015

An Interview with Dr Lester Grinspoon

Dr Lester Grinspoon, Associate Professor Emeritus of Psychiatry at Harvard Medical School, Boston, Massachusetts, United States, researched the medicinal legitimacy of cannabis prohibition 45 years ago and discovered an immense chain of lies served as a base for sending millions of people to jail. Since then he became an advocate for telling the truth about cannabis. The author, Patrick Dewals, has a Bachelor in Nursing (Mental Health), Masters in Political Science and is a student of political philosophy (Belgium), held a telephone interview (Skype conversation) with him at the end of August 2015.

PD: Can you tell me how you became interested in 'marihuana'?

Dr Lester Grinspoon: Well it began in 1966. During my anti-Vietnam activism I met Carl Sagan and he and I became very good friends. When I met Carl Sagan I was convinced that cannabis was a very harmful drug. Going to his house one day I discovered that he smoked cannabis and so did many of his friends. Now these were not unsophisticated people and I tried to tell Carl how harmful cannabis was but he responded in a joyful manner that it wasn’t harmful at all.

With this experience came the idea of writing a paper which would summarise the medical scientific basis for cannabis prohibition. At that time cannabis prohibition was leading to the arrest of 300,000 people, mainly young people ... 89% for simple possession. For me it became important that this prohibition was justified. It was in the library of the Medical School that I found out that I was completely wrong about the harmful effects of cannabis. Not only was it not harmful it was remarkably non-toxic and the 'drug' itself was not causing harm to the user but the policy of arresting people did. Some went to prison for having it and others saw their career goals compromised.

So I wrote an article about the subject and it was published in the International Journal of Psychiatry. One of the few people who read it was the editor of Scientific American. He asked me to reduce the article so it could fit in his magazine and he would then publish it as the lead article in one of the coming issues. When my article was published in the November 1969 issue, it caused a huge tsunami, so to speak ... Eventually I wrote my book 'Marihuana Reconsidered', that came out in 1971, with the Harvard University Press. When I was doing the research for my book I did not only find out that cannabis was not harmful but I started to understand why people would use it, what the attraction was for them and I decided, at the age of 42, that I was going to use it as well. It was just too interesting an experience to let go. But I knew that if the book would be a success there would be a good chance for me to be asked to testify before a congressional session or senate committee.

Because I didn’t want my own experiences with cannabis to make my testimony less objective, in the view of others, I decided that I could only use cannabis, even being interested as I was, two years after the publishing of my book. And indeed I ended up testifying before a senate committee. I remember a big tall senator who was rather doubtful about all I said, asking me “Doctor did you ever use cannabis?” and I answered “Senator I would be glad to answer that question if you could tell me that if I gave you an affirmative answer it would make you more sympathetic to my answer or less.” He stared at me saying “You sir, are being impertinent” and he walked out the back-door. Later that day, when I drove home, I said to my wife Betsy “The time has come” and sometime that week I would experience cannabis for the first time.

PD: You said earlier that through the research for your first book you came to understand why people would use cannabis. What are the reasons people use it?

Dr Lester Grinspoon: Most people are familiar with the recreational use. But along with this use cannabis has an ancient history as a medicine as well. We know that Shen Nung, a Chinese emperor, who lived about 5.000 years ago already used cannabis as a medicine. In modern western medicine we had to wait until the mid 19th century for the introduction of cannabis through an Englishman named William O’Shaughnessy. At that time he worked in Calcutta and observed the indigenous people using cannabis as a medicine. He started studies on animals to be sure it was safe and published his studies when he came back to England. Between 1849, the year O’Shaughnessy published his first paper, and 1900, I came across about 100 critical papers about cannabis as a medicine in my review of the literature.

The third use is the enhancement of a broad range of human activities. Everybody that has used cannabis knows that an ordinary meal can taste like a culinary treat and that it can enhance sexual experiences. But these are enhancements that are right there on the surface. Once one becomes more experienced with cannabis he can experience or appreciate phenomena in another way, for example understand art in a better way, use it for creative purposes or spirituality.

PD: When you published your first book 'Marihuana Reconsidered' in 1971, which was a controversial book at that time, what were the reactions of your peers and other scholars?

Dr Lester Grinspoon: Well yes, there was a lot of reaction. I remember the most significant of all. I was put up for early professorship by my chief at Harvard Medical School. At that time I had already published about 70 papers about schizophrenia and I had some expertise in this domain. So when my chief came back from the promotions committee he told me that the committee members loved my work on schizophrenia but they hated 'Marihuana Reconsidered' because it was much too controversial.

PD: Even with all the data that you used to support your work?

Dr Lester Grinspoon: Oh yes, I just couldn’t believe it ... When I was leaving his office my chief said to me, “They asked me to ask you a question, what are you planning to do next”. I said that I was an intellectual and that I did not know yet, which was a kind of lie, but that I wanted to have the freedom to go my way. The affair resulted in the turn-down of my candidacy for professorship at that moment and I had to wait till 1995 to become professor at Harvard, twenty years after my first candidature. In the beginning I was heartbroken but because I did not become a professor I could skip a lot of department meetings and other things, so I had a lot of time for my own research. Because of the free time I started to become active against the cannabis prohibition that was and still is very destructive in the American society.

PD: What can you tell me about cannabis as an addictive substance and not holding any medicinal benefits?

Dr Lester Grinspoon: Those are the myths about it. There are still people that think that it is addictive. They say that about 10% of the users become addicted. I don’t see it as an addictive substance. Sure you see some people using it all the time, especially many young people, but they do it because they did not figure out yet what to do with their lives. I used it for more than four decades, almost everyday, when there were times I could not use it I would not encounter any problems. Once I had to go to Malaysia for ten days to meet with a man that was caught with drugs over there and who was sentenced to death. Of course I did not bring cannabis with me and I felt good. I missed it but I felt nothing more.

PD: So marijuana addiction is just a myth?

Dr Lester Grinspoon: I don’t believe there is such a thing as cannabis addiction but common people are very concerned when they discover that their college kid is using cannabis. They will get upset and take him to the psychiatrist. This doctor has no other choice than diagnosing the youngster as a cannabis addict, like is mentioned in the DSM, because without putting a label on the ‘patient’ he will not be reimbursed. Afterwards people use this data to show that 9 or 10 % of the cannabis users are addicted, but that is simply not true. I remember that one of my students who smoked cannabis decided one day to stop using it to prove to himself he was not addicted. I thought it was a good idea and I said to myself let’s stop for 40 days and see how it goes. I had no problem at all.

PD: Do you think that doctors and therapists that work in rehab., hospitals have a conflict of interest? I mean, if a cannabis user is no longer labelled and treated as an addict a lot of them would find themselves without a job, no?

Dr Lester Grinspoon: Exactly right! They have, as I said above, to diagnose cannabis users as addicted people or miss their reimbursement. But you can’t compare cannabis with opiates or alcohol. Especially the alcohol addicts can have severe withdrawal symptoms. But you will not have those with cannabis.

PD: Can cannabis cause psychosis or schizophrenia?

Dr Lester Grinspoon: Absolutely not! Schizophrenia is a disorder which one is born with but it doesn’t always manifest itself. Usually it is during adolescence that it starts showing. The one way that the use of cannabis could be related to schizophrenia is when people who are not used to cannabis start smoking and become anxious or paranoid which is, of course, uncomfortable ... I can imagine that with someone who is cannabis naive and has that kind of experience it can occur as a precipitating event. Many schizophrenics say their psychotic episode started after such a precipitating event. Those events can range from an automobile accident or the death of a loved one. And I can imagine, I have never seen this, that the naive use of cannabis can act as a precipitating event.

PD: But then the use of cannabis is not the cause of the schizophrenic disorder. The person was born with it?

Dr Lester Grinspoon: Look, it is a very simple exercise. The prevalence of schizophrenia is 1% around the world, across all different cultures. Given the amount of people who started smoking cannabis, including adolescents (which I wished wouldn’t do it because their brain is not fully developed yet so they would be better waiting until their twenties), no scientist picked up even the tiniest increase in the prevalence of schizophrenia. So the people who write this cannot prove it.

PD: In Belgium, our Minister of Health, Maggie De Block, who is a doctor as well, says you can’t use cannabis as a medicine because there is no proof ... According to her the only thing useful is Sativex and only for MS-patients. What is your comment on that?

Dr Lester Grinspoon: Let me start with saying that Sativex is cannabis! To say that you could use Sativex and not smoke cannabis to have a similar effect is a silly thing to say. And to state that there is no evidence is nonsense. There are mountains of anecdotal evidence, you cannot just deny them. We are used to the idea that medicines come from pharmaceutical enterprises. After they did double blind tests with them. But this is a plant, and you can not patent a plant and have the exclusive licence to sell it. That’s why the pharmaceutical enterprises are not interested in doing very expensive tests with cannabis, because at the end of a positive test anyone could bring a medication on the market.

PD: Are you saying that cannabis is a great medicine for the people but not for the pharmaceutical enterprises, for them it is worthless?

Dr Lester Grinspoon: Absolutely! Another reason why you should not be worrying about using cannabis is because it is not toxic. I remember when I had, for the first time, a patient with Crohn’s disease. Even after surgery she was still compromised in her work because of it. So I said to her, "I don’t know if cannabis will help you enough but I would try it. If it doesn’t help you it surely is not going to hurt you". And today, if you read the medical literature, it became a very important treatment for people with Crohn’s disease. Some people say to me you should not say to people to use cannabis for this or for that. But that is a silly thing, because it might help you and surely will not hurt you. If it does help you, you are very fortunate because it has no side effects and it will always be cheap.